The proposed research tests the efficacy of a mental health nursing model within a generalized public health agency for the prevention of social-emotional disturbance or attachment failure in infants and/or developmental retardation in multiple risk families. The nursing intervention includes individualized prenatal and postnatal home contact to assure the mother's well being so that she can provide the nurturance needed for her infant. In the first phase, Wave I, a targeted clinical protocol for guiding the nursing care (N=60 cases) will be tested and compared to the regular public health nursing care (N=84 cases). All mothers will be enrolled in the Seattle-King County Health Department MCH program which involves prenatal and postpartum clinic visits. The tested clinical protocol will then be disseminated to the public health nurses and a replication of the original clinical protocol (N=48 cases) will be carried out in the second phase, Wave II. Assessment of the impact of this nursing model will occur at regular intervals during the child's first three years of life. For the children, we will be determining whether the intervention has resulted in normal sensory motor and cognitive development, secure attachments to the mother and normal physical development. For the mothers, we will be focusing on changes in her social skills, her daily living skills and her ability to enter into a supportive and synchronous relationship with her infant. For the infant and mother together, we will be looking for improvements in the quality of interaction, especially in the mutually responsive aspects of the interaction that we describe as synchrony.